What Is Bendopnea?

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Bendopnea is shortness of breath (dyspnea) experienced within 30 seconds of bending over at the waist. It occurs in response to shifts in fluid and pressure on the abdomen. It is a sign of worsening heart failure and so requires emergency medical attention.

Recognition and understanding of bendopnea is relatively new. In 2014, after noticing some patients with heart failure experienced dyspnea within seconds of bending over, researchers at the University of Texas did a study to assess this symptom's frequency and determine its medical significance.  

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Bendopnea Symptoms

Shortness of breath—dyspnea—is the singular symptom of bendopnea. Sometimes dyspnea is accompanied by pressure or tightness in the chest or a feeling of suffocation that can in turn bring on feelings of panic.

In a 2016 study, people who experienced bendopnea were found to have a higher incidence of other types of dyspnea, namely orthopnea (shortness of breath when lying down) and paroxysmal nocturnal dyspnea (PND) (dyspnea so dramatic it can awaken a person from deep sleep).

Enlargement of both atria and pulmonary artery systolic pressure were more frequent in these patients as well, as was significant swelling the legs and more advanced heart failure.

Causes

Bendopnea occurs when the heart can't compensate for fluid shifts and pressure placed on the abdomen that result when you bend over. People with heart failure tend to retain higher-than-normal amounts of fluid and so they are especially vulnerable to the movement of fluid and the stress it puts on the heart.

Bendopnea seems to be associated with heart failure that is more advanced or poorly controlled and is usually a sign of worsening heart failure. It also is associated with a significant positional elevation of right- and left-sided filling pressures.

Bendopnea also can occur in people who have large abdomens who don’t have heart failure.

Diagnosis

Testing for bendopnea is a straightforward matter of having a patient sit down and bend over at the waist. If they experience shortness of breath within 30 seconds of doing this, bendopnea is diagnosed.

Although bendopnea is a sign that heart failure is poorly controlled or getting worse, it is not regarded as a screening tool for heart failure. In other words, if you vend over and suddenly have trouble breathing it is not a definitive sign you have heart failure. In fact, if you do have heart failure you've likely experienced symptoms of the condition and already been diagnosed.

Treatment

Since bendopnea is a symptom of heart failure, there is no targeted treatment for it. However, it may be alleviated if heart failure is well controlled. This typically involves a combination of medications, including diuretics, which remove excess fluid from the body, restriction of salt from the diet, as sodium contributes to fluid retention, and, in advanced cases, implantation of a defibrillator or other procedures.

It's important to be aware there is no cure for heart failure, and so targeted treatment and compliance are essential to preventing the condition from worsening and in mitigating symptoms such as bendopnea.

A Word From Verywell

If you bend forward and find yourself unable to breathe, the experience is bound to be disconcerting. It's never comfortable to experience shortness of breath. If you've been diagnosed with heart failure, bendopnea is a signal your condition could be worsening. Pay attention to that signal and seek emergency medical care. If you do not have heart failure and happen to be overweight, shortness of breath caused by bending forward is likely to be a side effect (and a sign you would benefit from losing weight). However, do report bendopnea to your doctor.

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  1. Thibodeau JT, Turer AT, Gualano S, et al. Characterization of a novel symptom of advanced heart failure: Bendopnea. JACC Heart Fail. 2014;2(1):24-31. doi:10.1016/j.jchf.2013.07.009

  2. Baeza‐Trinidad R, Mosquera‐Lozano J, El Bikri L. Assessment of bendopnea impact on decompensated heart failure. Eur J Heart Fail. 2016 July;19(1):111-115. doi:10.1002/ejhf.610

  3. Cleveland Clinic. These common symptoms of heart failure may signify your heart isn’t functioning as well as it should. May 6, 2019.